本文選題：慢性高血壓 + 附加型子癇前期　； 參考：《蘇州大學(xué)》2014年碩士論文

【摘要】：目的：探討慢性高血壓合并妊娠對圍生期結(jié)局的影響，，以及發(fā)生附加子癇前期的危險因素。 方法：選擇蘇州大學(xué)附屬第一醫(yī)院2011年10月~2013年11月間收治的164例行正規(guī)產(chǎn)檢的慢性高血壓合并妊娠孕婦為研究對象。根據(jù)其是否并發(fā)子癇前期分為慢性高血壓合并子癇前期組（PE組，80例）和慢性高血壓未并發(fā)子癇前期組（N—PE組，84例）。比較兩組患者的并發(fā)癥和胎兒預(yù)后情況，探討導(dǎo)致母兒不良預(yù)后的高危因素。 結(jié)果：（1）PE組胎盤早剝和產(chǎn)后出血的發(fā)生率明顯高于N-PE組（8.8%vs.1.2%，12.5%vs.2.4%；P＜0.05）。（2）PE組平均分娩孕周小于N-PE組，差異明顯（35.3±4.1vs.38.1±2.4；P＜0.001）；兩組＜37周早產(chǎn)、＜34周早產(chǎn)、＜32周早產(chǎn)率分別比較，PE組高于N-PE組，差異有統(tǒng)計學(xué)意義（P＜0.001）。（3）胎兒宮內(nèi)生長受限發(fā)生率PE組高于N-PE組（26.3%vs.7.1%，P＜0.05）。（4）新生兒轉(zhuǎn)NICU發(fā)生率，PE組高于N-PE組，差異有統(tǒng)計學(xué)意義（33.7%vs.10.7%，P＜0.001）。（5）單因素分析：年齡＞35歲、妊娠初期基礎(chǔ)血壓為重度高血壓、平均動脈壓≥114mmHg、肥胖、高血壓家族史是影響慢性高血壓合并妊娠患者在正規(guī)產(chǎn)檢情況下發(fā)生附加子癇前期的危險因素；而多因素logistic回歸分析顯示：平均動脈壓≥114mmHg、肥胖是影響慢性高血壓合并妊娠患者在正規(guī)產(chǎn)檢情況下并發(fā)子癇前期的獨立危險因素（ORs:7.018、2.656；95%CIs:2.684-18.354、1.045-6.749）。結(jié)論：慢性高血壓合并子癇前期患者的母兒病率和圍產(chǎn)兒病死率明顯高于未合并子癇前期患者，平均動脈壓≥114mmHg、肥胖是慢性高血壓合并妊娠患者在正規(guī)產(chǎn)檢情況下并發(fā)子癇前期的獨立因素。
[Abstract]:Objective: to investigate the effect of chronic hypertension combined with pregnancy on perinatal outcome and the risk factors of preeclampsia. Methods: 164 pregnant women with chronic hypertension and pregnancy were selected from October 2011 to November 2013 in the first affiliated Hospital of Suzhou University. According to whether preeclampsia was complicated by chronic hypertension and preeclampsia, 80 patients were divided into two groups: chronic hypertension with preeclampsia (n = 80) and chronic hypertension without preeclampsia (n = 84) with preeclampsia (n = 84). The complications and fetal prognosis of the two groups were compared to explore the high risk factors leading to poor maternal and fetal prognosis. Results the incidence of placental abruption and postpartum hemorrhage in the PE group was significantly higher than that in the N-PE group, which was significantly higher than that in the N-PE group (P < 0.05). The incidence of placental abruption and postpartum hemorrhage in the PE group was significantly higher than that in the N-PE group (P < 0.05), and was significantly higher in the PE group than in the N-PE group. The incidence of fetal intrauterine growth restriction in PE group was higher than that in N-PE group (P < 0.05). The incidence of NICU in PE group was higher than that in N-PE group. The difference was statistically significant (33.7 vs.10.7 + P < 0.001.5) univariate analysis showed that age > 35 years old, the basic blood pressure in the first trimester of pregnancy was severe hypertension. The mean arterial pressure 鈮

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